Magyar Sebészet
Volume/Issue:
Volume 67: Issue 6
Is radicality granted? Transanal endoscopic microsurgery for the treatment of rectal neoplasia – clinicopathological viewpoint
Authors:
Balázs ÁcsSemmelweis Egyetem II. Sz. Patológiai Intézet Budapest

Search for other papers by Balázs Ács in
Current site
Google Scholar
PubMedClose
,
A. Marcell SzászSemmelweis Egyetem II. Sz. Patológiai Intézet Budapest

Search for other papers by A. Marcell Szász in
Current site
Google Scholar
PubMedClose
,
Janina KulkaSemmelweis Egyetem II. Sz. Patológiai Intézet Budapest

Search for other papers by Janina Kulka in
Current site
Google Scholar
PubMedClose
,
László HarsányiSemmelweis Egyetem I. Sz. Sebészeti Klinika 1082 Budapest Üllői út 78.

Search for other papers by László Harsányi in
Current site
Google Scholar
PubMedClose
, and
Attila ZarándSemmelweis Egyetem I. Sz. Sebészeti Klinika 1082 Budapest Üllői út 78.

Search for other papers by Attila Zaránd in
Current site
Google Scholar
PubMedClose
View More View Less
Pages:
329–333
Online Publication Date:
12 Dec 2014
Publication Date:
01 Dec 2014
Article Category:
Research Article
DOI:
https://doi.org/10.1556/maseb.67.2014.6.2
Keywords:
TEM; transanalis endoscopos mikrosebészet; minimálisan invasiv sebészet rectumtumor; rectumadenoma; TEM; transanal endoscopic microsurgery; minimal invasive surgery; rectal cancer; rectal adenoma
Restricted access

A rectum középső és alsó harmada válogatott daganatainak ellátására kifejlesztett transanalis endoscopos mikrosebészeti (TEM) eljárás alacsony recidíva- és szövődményrátájú, így a hagyományos műtéti technikák alternatívája lehet, ha az onkológiai radikalitás szempontjából nem jelent kompromisszumot. A TEM-eljárás 2013 őszétől érhető el – Magyarországon második centrumként, de jelenleg a legkorszerűbb felszereltségű − a Semmelweis Egyetem I. Sz. Sebészeti Klinikáján. Jelen vizsgálatunkban célul tűztük ki, hogy az utóbbi egy év klinikopatológiai adatait elemezzük. 2013. szeptember és 2014. szeptember között TEM-technikával operált betegek adatait elemeztük retrospektív módon. 44 beteg került TEM-eljárással ellátásra rectumneoplasia miatt. Szövettani vizsgálattal az elváltozások között 12 low grade adenoma, 14 high grade adenoma, 17 invasiv adenocarcinoma és 1 neuroendokrin tumor volt. A low grade és high grade adenomák, illetve adenocarcinomák mérete között nem tudtunk szignifikáns különbséget kimutatni (p = 0,210). A 30 mm alatti és feletti elváltozások között a szövettani diagnózisok tekintetében szignifikáns különbséget nem tapasztaltunk (p = 0,424). A 44 esetből 13 esetben a praeoperativ szövettani vizsgálat kedvezőbb prognózisú elváltozást jelzett, mint a TEM-excisiós preparátumon végzett végleges szövettani elemzés (p < 0,001). A szövettani vizsgálat 41 esetben (95,3%) igazolta az épben történő kimetszést. Mindazonáltal a több darabban vagy mucosectomiával történő polypectomia – különösen nagyméretű adenomák esetében – nem tekinthető elegendő kezelésnek, ezért – más kutatócsoportokhoz hasonlóan – javasoljuk a TEM-technikával a teljes rectumfalra kiterjedő excisiót. A pT2 stádiumú daganatok esetében a választandó eljárás tekintetében a jelenleg is zajló prospektív klinikai vizsgálatok fognak bizonyosságot adni.

  • Sándor J, Ádány R: A daganatos megbetegedések incidenciája és az általuk okozott halálozás alakulása Magyarországon. In: Az onkológia alapjai (szerk. Kásler M). Medicina, Budapest, 2011, 71–110

    Ádány R , '', in Az onkológia alapjai , (2011 ) -.

  • Tusnády G, Gaudi I, Rejto L, Kásler M, Szentirmay Z: A magyar daganatos betegek túlélési esélye a Nemzeti Rákregiszter adatai alapján. [Survival chances of Hungarian cancer patients in the National Cancer Registry]. Magy Onkol 2008; 52: 339–49

    Szentirmay Z , 'A magyar daganatos betegek túlélési esélye a Nemzeti Rákregiszter adatai alapján. [Survival chances of Hungarian cancer patients in the National Cancer Registry] ' (2008 ) 52 Magy Onkol : 339 -49 .

    • Search Google Scholar

  • Heald RJ, Ryall RDH: Recurrence and survival after total mesorectal excision for rectal cancer. The Lancet 1986; 327: 1479–82

    Ryall RDH , 'Recurrence and survival after total mesorectal excision for rectal cancer ' (1986 ) 327 The Lancet : 1479 -82 .

    • Search Google Scholar

  • Law WL, Chu KW: Anterior resection for rectal cancer with mesorectal excision: a prospective evaluation of 622 patients. Ann Surg 2004; 240: 260–8

    Chu KW , 'Anterior resection for rectal cancer with mesorectal excision: a prospective evaluation of 622 patients ' (2004 ) 240 Ann Surg : 260 -8 .

    • Search Google Scholar

  • Buess G, Hutterer F, Theiss J, Bobel M, Isselhard W, Pichlmaier H: Das System für die transanale endoskopische Rectumoperation. [A system for a transanal endoscopic rectum operation.] Chirurg 1984; 55: 677–80

    Pichlmaier H , 'Das System für die transanale endoskopische Rectumoperation ' (1984 ) 55 [A system for a transanal endoscopic rectum operation.] Chirurg : 677 -80 .

    • Search Google Scholar

  • Langer C, Liersch T, Suss M, Siemer A, Markus P, Ghadimi BM, Fuzesi L, Becker H: Surgical cure for early rectal carcinoma and large adenoma: transanal endoscopic microsurgery (using ultrasound or electrosurgery) compared to conventional local and radical resection. Int J Colorectal Dis 2003; 18: 222–9

    Becker H , 'Surgical cure for early rectal carcinoma and large adenoma: transanal endoscopic microsurgery (using ultrasound or electrosurgery) compared to conventional local and radical resection ' (2003 ) 18 Int J Colorectal Dis : 222 -9 .

    • Search Google Scholar

  • Guerrieri M, Baldarelli M, Morino M, Trompetto M, Da Rold A, Selmi I, Allaix ME, Lezoche G, Lezoche E: Transanal endoscopic microsurgery in rectal adenomas: experience of six Italian centres. Dig Liver Dis 2006; 38: 202–7

    Lezoche E , 'Transanal endoscopic microsurgery in rectal adenomas: experience of six Italian centres ' (2006 ) 38 Dig Liver Dis : 202 -7 .

    • Search Google Scholar

  • Winde G, Nottberg H, Keller R, Schmid KW, Bunte H: Surgical cure for early rectal carcinomas (T1). Transanal endoscopic microsurgery vs. anterior resection. Dis Colon Rectum 1996; 39: 969–76

    Bunte H , 'Surgical cure for early rectal carcinomas (T1). Transanal endoscopic microsurgery vs. anterior resection ' (1996 ) 39 Dis Colon Rectum : 969 -76 .

    • Search Google Scholar

  • Zarand A: TEO: Minimálisan invazív rectumsebészet. Rövid áttekintés. [TEO: minimally invasive surgery of the rectum. A short review.] Magy Seb 2014; 67: 15–7

    Zarand A , 'TEO: Minimálisan invazív rectumsebészet. Rövid áttekintés. [TEO: minimally invasive surgery of the rectum ' (2014 ) 67 A short review.] Magy Seb : 15 -7 .

    • Search Google Scholar

  • De Graaf EJ, Burger JW, van Ijsseldijk AL, Tetteroo GW, Dawson I, Hop WC: Transanal endoscopic microsurgery is superior to transanal excision of rectal adenomas. Colorectal Dis 2011; 13: 762–7

    Hop WC , 'Transanal endoscopic microsurgery is superior to transanal excision of rectal adenomas ' (2011 ) 13 Colorectal Dis : 762 -7 .

    • Search Google Scholar

  • Moore JS, Cataldo PA, Osler T, Hyman NH: Transanal endoscopic microsurgery is more effective than traditional transanal excision for resection of rectal masses. Dis Colon Rectum 2008; 51: 1026–30; discussion 1030–1

    Hyman NH , 'Transanal endoscopic microsurgery is more effective than traditional transanal excision for resection of rectal masses ' (2008 ) 51 Dis Colon Rectum : 1026 -30 .

    • Search Google Scholar

  • McCloud JM, Waymont N, Pahwa N, Varghese P, Richards C, Jameson JS, Scott AN: Factors predicting early recurrence after transanal endoscopic microsurgery excision for rectal adenoma. Colorectal Dis 2006; 8: 581–5

    Scott AN , 'Factors predicting early recurrence after transanal endoscopic microsurgery excision for rectal adenoma ' (2006 ) 8 Colorectal Dis : 581 -5 .

    • Search Google Scholar

  • Serra-Aracil X, Mora-Lopez L, Alcantara-Moral M, Caro-Tarrago A, Gomez-Diaz CJ, Navarro-Soto S: Transanal endoscopic surgery in rectal cancer. World J Gastroenterol 2014; 20: 11538–45

    Navarro-Soto S , 'Transanal endoscopic surgery in rectal cancer ' (2014 ) 20 World J Gastroenterol : 11538 -45 .

    • Search Google Scholar

  • Absar MS, Haboubi NY: Colonic neoplastic polyps: biopsy is not efficient to exclude malignancy. The Trafford experience. Tech Coloproctol 2004; 8(Suppl 2): s257–60

    Haboubi NY , 'Colonic neoplastic polyps: biopsy is not efficient to exclude malignancy. The Trafford experience ' (2004 ) 8(Suppl 2) Tech Coloproctol : s257 -60 .

    • Search Google Scholar

  • Buess G, Mentges B, Manncke K, Starlinger M, Becker HD: Technique and results of transanal endoscopic microsurgery in early rectal cancer. Am J Surg 1992; 163: 63–9; discussion 69–70

    Becker HD , 'Technique and results of transanal endoscopic microsurgery in early rectal cancer ' (1992 ) 163 Am J Surg : 63 -9 .

    • Search Google Scholar

  • Christoforidis D, Cho HM, Dixon MR, Mellgren AF, Madoff RD, Finne CO: Transanal endoscopic microsurgery versus conventional transanal excision for patients with early rectal cancer. Ann Surg 2009; 249: 776–82

    Finne CO , 'Transanal endoscopic microsurgery versus conventional transanal excision for patients with early rectal cancer ' (2009 ) 249 Ann Surg : 776 -82 .

    • Search Google Scholar

  • Heidary B, Phang TP, Raval MJ, Brown CJ: Transanal endoscopic microsurgery: a review. Can J Surg 2014; 57: 127–38

    Brown CJ , 'Transanal endoscopic microsurgery: a review ' (2014 ) 57 Can J Surg : 127 -38 .

    • Search Google Scholar

  • Lezoche G, Paganini AM, Campagnacci R, Ghiselli R, Pelloni M, Rombini A, Guerrieri M: Treatment of rectal cancer by transanal endoscopic microsurgery: review of the literature. Minerva Chir 2013; 68: 1–9

    Guerrieri M , 'Treatment of rectal cancer by transanal endoscopic microsurgery: review of the literature ' (2013 ) 68 Minerva Chir : 1 -9 .

    • Search Google Scholar

  • Doornebosch PG, Ferenschild FT, de Wilt JH, Dawson I, Tetteroo GW, de Graaf EJ: Treatment of recurrence after transanal endoscopic microsurgery (TEM) for T1 rectal cancer. Dis Colon Rectum 2010; 53: 1234–9

    Graaf EJ , 'Treatment of recurrence after transanal endoscopic microsurgery (TEM) for T1 rectal cancer ' (2010 ) 53 Dis Colon Rectum : 1234 -9 .

    • Search Google Scholar

  • Tytherleigh MG, Warren BF, Mortensen NJ: Management of early rectal cancer. Br J Surg 2008; 95: 409–23

    Mortensen NJ , 'Management of early rectal cancer ' (2008 ) 95 Br J Surg : 409 -23 .

  • Kikuchi R, Takano M, Takagi K, Fujimoto N, Nozaki R, Fujiyoshi T, Uchida Y: Management of early invasive colorectal cancer. Risk of recurrence and clinical guidelines. Dis Colon Rectum 1995; 38: 1286–95

    Uchida Y , 'Management of early invasive colorectal cancer. Risk of recurrence and clinical guidelines ' (1995 ) 38 Dis Colon Rectum : 1286 -95 .

    • Search Google Scholar

  • Haggitt RC, Glotzbach RE, Soffer EE, Wruble LD: Prognostic factors in colorectal carcinomas arising in adenomas: implications for lesions removed by endoscopic polypectomy. Gastroenterology 1985; 89: 328–36

    Wruble LD , 'Prognostic factors in colorectal carcinomas arising in adenomas: implications for lesions removed by endoscopic polypectomy ' (1985 ) 89 Gastroenterology : 328 -36 .

    • Search Google Scholar

  • Issa N, Murninkas A, Powsner E, Dreznick Z: Long-term outcome of local excision after complete pathological response to neoadjuvant chemoradiation therapy for rectal cancer. World J Surg 2012; 36: 2481–7

    Dreznick Z , 'Long-term outcome of local excision after complete pathological response to neoadjuvant chemoradiation therapy for rectal cancer ' (2012 ) 36 World J Surg : 2481 -7 .

    • Search Google Scholar

  • Tiernan JP, Ansari I, Hirst NA, Millner PA, Hughes TA, Jayne DG: Intra-operative tumour detection and staging in colorectal cancer surgery. Colorectal Dis 2012; 14: e510–20

    Jayne DG , 'Intra-operative tumour detection and staging in colorectal cancer surgery ' (2012 ) 14 Colorectal Dis : e510 -20 .

    • Search Google Scholar

  • Cahill RA, Anderson M, Wang LM, Lindsey I, Cunningham C, Mortensen NJ: Near-infrared (NIR) laparoscopy for intraoperative lymphatic road-mapping and sentinel node identification during definitive surgical resection of early-stage colorectal neoplasia. Surg Endosc 2012; 26: 197–204

    Mortensen NJ , 'Near-infrared (NIR) laparoscopy for intraoperative lymphatic road-mapping and sentinel node identification during definitive surgical resection of early-stage colorectal neoplasia ' (2012 ) 26 Surg Endosc : 197 -204 .

    • Search Google Scholar
  • Collapse
  • Expand
Cover Magyar Sebészet
Magyar Sebészet
Print ISSN:
0025-0295
Online ISSN:
1789-4301
Submit Your Manuscript

 

The author instruction is available in PDF.
Please, download the file from HERE

 

Senior editors

Editor(s)-in-Chief: Oláh, Attila

Editorial Board

  • DR. BÁLINT ANDRÁS
  • DR. BEZSILLA JÁNOS
  • DR. BOROS MIHÁLY
  • DR. BURSICS ATTILA
  • DR. DAMJANOVICH LÁSZLÓ
  • DR. ENTZ LÁSZLÓ
  • DR. GULYÁS GUSZTÁV
  • DR. HARSÁNYI LÁSZLÓ
  • DR. HORVÁTH ÖRS PÉTER
  • DR. ISTVÁN GÁBOR
  • DR. KECSKÉS LÁSZLÓ
  • DR. KÓBORI LÁSZLÓ
  • DR. KUPCSULIK PÉTER
  • DR. LÁZÁR GYÖRGY
  • DR. LESTÁR BÉLA
  • DR. MÁTRAI ZOLTÁN
  • DR. MOHOS ELEMÉR
  • DR. MOLNÁR F. TAMÁS
  • DR. ONDREJKA PÁL
  • DR. PAPP ANDRÁS
  • DR. RÉNYI-VÁMOS FERENC
  • DR. ROMICS LÁSZLÓ JR.
  • DR. SÓTONYI PÉTER
  • DR. SZIJÁRTÓ ATTILA
  • DR. SZŰCS ÁKOS
  • DR. VEREBÉLY TIBOR
  • DR. VERECZKEI ANDRÁS

Petz Aladár County Teaching Hospital, Surgery
Vasvári Pál út 2. H-9024 Győr, Hungary
Phone: +36 96 503 320 --- Fax: +36 96 507 936
E-mail: olaha@petz.gyor.hu

Indexing and Abstracting Services:

  • Index Medicus
  • PubMed Central
  • CABELLS Journalytics

 

2020  
CrossRef Documents 37
WoS Cites 45
Wos H-index 8
Days from submission to acceptance 60
Days from acceptance to publication 63

 

2019  
WoS
Cites		 63
CrossRef
Documents		 31

 

Magyar Sebészet
Publication Model Hybrid
Submission Fee none
Article Processing Charge 900 EUR/article
Printed Color Illustrations 40 EUR (or 10 000 HUF) + VAT / piece
Regional discounts on country of the funding agency World Bank Lower-middle-income economies: 50%
World Bank Low-income economies: 100%
Further Discounts Editorial Board / Advisory Board members: 50%
Corresponding authors, affiliated to an EISZ member institution subscribing to the journal package of Akadémiai Kiadó: 100%
Subscription fee 2023 Online subsscription: 292 EUR / 380 USD
Print + online subscription: 336 EUR / 450 USD
Subscription Information

Online subscribers are entitled access to all back issues published by Akadémiai Kiadó for each title for the duration of the subscription, as well as Online First content for the subscribed content.
Purchase per Title Individual articles are sold on the displayed price.

Magyar Sebészet
Language Hungarian
Size A4
Year of
Foundation		 1947
Volumes
per Year		 1
Issues
per Year		 4
Founder Magyar Sebész Társaság -- Hungarian Surgical Society
Founder's
Address		 H-1082 Budapest, Hungary Üllői út 78.
Publisher Akadémiai Kiadó
Publisher's
Address		 H-1117 Budapest, Hungary 1516 Budapest, PO Box 245.
Responsible
Publisher		 Chief Executive Officer, Akadémiai Kiadó
ISSN 0025-0295 (Print)
ISSN 1789-4301 (Online)

Monthly Content Usage

Abstract Views Full Text Views PDF Downloads
Dec 2022 76 0 0
Jan 2023 23 0 0
Feb 2023 6 1 1
Mar 2023 5 0 0
Apr 2023 6 0 0
May 2023 10 0 0
Jun 2023 0 0 0